response system have considered models consistent with integrated
pluralistic governance and complementarity.93

These features of complementarity provide a safety net to assure
protection of the public’s health. Given the highly unpredictable nature of
public health threats, the existence of safeguards through complementary
institutions can be significantly beneficial in gap-filling functions, enhanced
response to social needs through pooled resources, and prevention of
overinfluence by interest groups.94 These potential advantages of
complementarity belie the usual concerns about redundancy focused on
inefficiency, cost, and lack of coordination. While overlapping or duplicative
multi-sectoral and multi-participant efforts to improve health can be
undermined by excessive fragmentation and collective action problems or by
misallocation of resources,95 even staunch critics of redundancy concede the
need for systemic resilience during circumstances that pose a “risk of
catastrophic and irreversible harms.”96 Moreover, such concerns about
fragmentation and inefficiency may be alleviated with efforts to engage in
strategic coordination and establish a systemic architecture designed to
minimize those harmful effects and maximize complementary roles.

B. Innovation in Policy and PracticeComplementarity across overlapping public health laws and systems alsocan spur innovation in policy and practice through the introduction offlexibility and adaptability in policy development and in practicalimplementation of public health strategies. A legal system hidebound byhierarchy or rigidly, and limited by aggressive anti-regulatory interpretationsof preemption doctrine, may not be able to engage in robust public healthprotection. By contrast, systems that exhibit complementarity and featureCover’s categories of synchronic or sequential redundancy createopportunities to protect public health through legal and policy

93. Id. at 444–45; see also U.S. DEP’T OF HEALTH AND HUMAN SERV., NATIONAL HEALTH
SECURITY STRATEGY OF THE UNITED STATES OF AMERICA 5–17 (2009),